GUIDANCE FOR PEOPLE WHO USE DRUGS DURING THE COVID-19 PANDEMIC What is this and who is this for? As people who use drugs, we are often left to the side to figure out why we might feel sick or unwell. Sometimes, the symptoms we get when we feel unwell will have different causes. Whether it’s drug withdrawal, a flu, or COVID-19, you deserve information to help you make decisions about your health. This isn’t about judgment–this is harm reduction, we are all figuring out how to stay safe and what that looks like for us and our community. We are treating COVID-19 as seriously as HEP-C, HIV/AIDS, and overdose because we value the lives of our participants, their loved ones, and communities. These tips and info can also be useful when you or your friends may be sick with a flu, cold, or cough which can spread germs through the air. So with urgency and love, we have decided to present this to you all while respecting your autonomy to make your own informed decisions.
Due to COVID-19 variants continuing to mutate and add up in numbers, transmission time has become more rapid and taking precautions against COVID-19 is more important than ever.
Be aware! Some early symptoms of withdrawal and COVID-19 infection are similar. These include fever and muscle soreness. If symptoms include a persistent/on-going cough, it could be COVID-19. If you have suddenly lost your sense of taste or smell, it is very likely you have contracted COVID-19.
You may be at an increased risk of becoming ill with COVID-19 if: 1.
2. 3.
You use opioids, which intensify respiratory depression alongside COVID-19. You are experience opioid withdrawal, which may worsen symptoms and discomfort, including breathing difficulties. You smoke drugs, like crack, meth, or weed, which may increase your difficulty breathing.
Being vaccinated will protect you against severe illness or death, but you may still get sick.
Opioid use and smoking drugs such as crack, meth, or weed could make breathing more difficult and withdrawal symptoms may worsen discomfort and breathing difficulties. Most Common Symptoms • Sore Throat • Muscle Aches • Fever • Cough • Shortness of breath • Diarrhea • Vomit • Loss of taste or smell How is COVID-19 spread? • Inhalation of respiratory droplets/fluids or airborne aerosols
•
carrying the virus Exposure to respiratory droplets on exposed mucous membranes (mouth, nose, eye) via a touch, splash, or spray
If You Think You’re Getting Sick
Avoid going to your local harm reduction and substance use treatment programs - Have them deliver supplies to you. Tell them you are sick so they can take steps to keep themselves safe. If they can’t deliver to you, ask them for other options like a friend picking up for you.
Be Prepared for Involuntary Withdrawal
Be ready to go through involuntary withdrawal. Your dealer might get sick or drug supply might be disrupted. Try to be prepared by stocking up. Talk to a medical provider about starting Suboxone or buprenorphine if you use opioids. Make sure you have all the necessary medications, food, and drinks needed to help detox. Try to have protein-based and electrolyte drinks like Pedialyte or Ensure on hand.
People who use drugs often have weaker immune systems, respiratory (breathing) problems, and other conditions that place them at a higher risk of getting COVID-19 infection. The coronavirus has had an outsize impact on the Black community and the failure to address the pandemic within a social justice framework supports white supremacy. CDC guidelines are based on impacts on healthcare systems; the CDC guidelines for your area might not be taking the risk to your individual health and safety into account. By looking at the number of cases in your area and how many tests are positive (aka the positivity rate) you can make your own informed decisions about what level of risk is acceptable for you and any health concerns you may have.
Help keep everybody safe by following this advice:
Avoid crowded places and wear a mask. You can reduce your risk for COVID-19 infection by staying at least six feet away from other people, avoiding touching your face, and washing your hands for at least 20 seconds with soap and water. It may not always be possible to follow this advice but taking any of these steps can help keep yourself and your community protected.
*Remember that practicing harm reduction can help you to avoid COVID-19 infection.
Additional Steps Can Help To Reduce Your Risk Of Getting Sick Drugs
If you have the money and are able, stock up on your drug(s) of choice to avoid shortages. For proper storage, the things you should try to avoid are air, heat, light and water. For powders you can add a silica gel packet in with it to keep it from getting damp. Pharmaceuticals do have an expiration date however studies show viability in almost all past that time, companies are very conservative with how long they’ll say their drugs last. If you can, begin to ration out your drugs as soon as you know your supply has been cut-off. Be prepared to go through withdrawals with whatever supplies make that the least uncomfortable for you. Try to have as many ways to contact dealers in your area as possible. Your access to drugs might be disrupted.
Alcohol
If you have the money, and are able, stock up on enough alcohol to last a few weeks. Try to ration your supply if possible, so that you have access to enough to avoid alcohol withdrawal, and things like seizures. One way to do this is by managing your alcohol use by consuming an amount of alcohol equivalent to 5oz of wine, 12oz of regular beer or 1.5oz of distilled liquor i.e whiskey, rum, brandy etc., hourly or as needed (the standard drink sizes for the three beverages
in ounces). You can also water down your drinks, both to keep you more hydrated and to make your supply last longer.
concentration)–like the ones distributed by harm reduction programs.
Harm Reduction Supplies
Don’t handle or touch other people’s drugs or equipment and don’t let them touch yours. Avoid buying and splitting packages of drugs with others, if possible, to limit the number of people handling drugs. If you must split the drugs, make sure the person who touches the drugs sterilizes their hands.
Be prepared for the possibility of syringe exchanges and drug treatment programs closing down, or requiring COVID-19 safety rules such as masking or proof of vaccination. If you are able, stockpile enough harm reduction supplies to last you a few weeks - longer if you are at higher risk of infection or complications. This includes things like naloxone, syringes, cookers, pipes, and straws. Get a Sharps container to get rid of used syringes. If you can’t get one, use something like a plastic laundry detergent bottle or soda bottle. Label these bottles “SHARPS CONTAINER”. Don’t overfill, needle points can puncture things like 2 liter plastic bottles. Once full, secure with heavy duty tape if possible. Syringes and other waste can not be recycled.
Methadone & Buprenorphine
Check with your medical provider to see if services might be changing. If you have a pre-existing condition that puts you at greater risk of getting sick, let your program know. Ask your program and provider if you can have take homes or more refills on your medications. This means that you don’t have to go to your provider to get new doses after your first collection.
Prepare your drugs yourself
About Masks
NEXT currently distributes surgical masks as part of the ordering process, which have a protective factor higher than a cloth mask in a closed space with little/no ventilation. This is not to say you will absolutely get sick if exposed, however with each new variant, COVID-19 has become more and more transmissible. Masks are also helpful in protecting against other illnesses like the flu. Keep in mind that approximate transmission time between no mask/no mask: 15 minutes. A well fitted n95 mask lets a maximum of 10% unfiltered air through, if two people are using them infection is unlikely.
Naloxone
Stock up on naloxone in the event of an unintentional overdose. Emergency services are likely to take longer than usual if your local hospitals are inundated with COVID-19 patients during a surge in cases.
Don’t Share Your Drug Use Supplies
If you have to share, wipe down glass or metal materials with alcohol and allow to dry completely before rinsing and re-using. Equipment you should clean includes crack or meth pipes; spoons (for smoking crack or freebasing), straws or other nasal tubes (for inhaling/ snorting); bongs, vapes, joints; and drinks. Trace amounts of blood leftover in cookers can also transmit bloodborne illnesses like Hep C or HIV. If you must share cookers, disinfect between uses or if you’re splitting a shot, piggyback doses using a third, sterile syringe.
Avoid Injecting Alone
The illegal drug supply continues to be unsafe and unreliable. Try not to use alone, especially if you inject drugs like heroin, fentanyl, or drugs that might have come into contact with them.
Clean Your Smoking Supplies
Use mouthpieces and pipe covers on your smoking supplies when possible. Frequently clean these mouthpieces and pipe covers using an alcohol-based cleaner (Like Purell or some other brand) or wipe (minimum 60% alcohol concentration).
Wipe down drug packages
Use an alcohol-based cleaner or wipe to immediately wipe down your packages. If your dealer carries drugs in their mouth or other personal places, ask them if they can stop doing this. Remember that antibacterial wipes don’t kill viruses but are better than nothing, especially if they contain alcohol.
Do not put drug bags or wraps in your mouth, vagina or anus If you must carry drugs in your body, clean vigorously with an alcohol-based cleanser both before and after you take it out. If carried in your mouth, use an alcohol-based mouthwash afterwards.
Wash your hands
with soap and hot water vigorously for at least 20 seconds (but longer if you can) every time you come into contact with others, after handling money and after you get your drugs packages. Paper towels are preferred for drying hands, or at least use a clean towel. If you cannot wash your hands, clean your hands with an alcohol-based cleaner or wipes (minimum 60% alcohol
Do you have questions about anything we mentioned in this brochure? Reach out to the friendly folks at NEXT who can help. New York: Nina: nina@nextdistro.org Other States: Nadia: nadia@nextdistro.org Special thanks to CTHRA for the content in this brochure. www.ghhrc.org